Lesley Russell

A report this week makes a strong economic and business case for increased efforts to provide workplaces that are healthy for both mind and body.

The report - Creating Mentally Healthy Workplaces - has been produced by the Mentally Healthy Workplace Alliance and is being championed by National Mental Health Commission chairman Professor Allan Fels.

Mental health disorders are leading causes of absenteeism, reduced work performance, increased employee turnover, compensation claims and long-term work incapacity. The impact extends to family and carers, and work colleagues. Economic analyses shows mental health disorders result in more than six million lost working days and cost Australian businesses around $11 billion every year. That figure is almost double the $6.3 billion spent annually on treatment.

Internationally recognised economist Martin Wolf, writing in the Financial Times earlier this year, saysmental illness is the developed world's most pressing health problem. He argues that given the considerable economic costs, providing effective workplace programs will pay for itself. This is borne out by the findings of this report: every dollar spent on effective mental health actions by a business or organisation returns $2.30 in benefits.

There continues to be significant stigma around mental illness but is this sufficient justification for the fact that governments, healthcare systems and employers have largely ignored the severity of the impacts of mental health disorders? Only one-third of people with a mental health problem get the treatment they need and we know little about the outcomes of that treatment or patient satisfaction with their care.

Such a situation would be considered untenable for cancer or diabetes. Yet the same principles of prevention, early intervention, evidence-based treatment, recovery and recognition that there will be relapses and interruptions to working capacity apply. The case for treating mental illness at least as energetically as physical illness is overwhelming.

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A recent Australian study calculates there are 9000 deaths every year because mental health patients are dying from preventable physical illnesses that are not diagnosed early and treated. On the other hand, depression is very common condition in people with chronic illness and is associated with a 17 to 46 per cent increase in healthcare costs and poorer health outcomes.

Having a healthy workforce is fundamental to the success of any business; and recognising and promoting mental health is an essential part of creating a safe and healthy workplace. The new report outlines six key areas for action - smarter work design, better work cultures, building resilience, early interventions, supporting recovery, and increased awareness - and provides evidence-based strategies for creating mentally healthy workplaces. A new website at HeadsUp.org.au explains how individual businesses can create a customised action plan and a supportive workplace culture.

With an estimated one in five employees affected by mental health problems, no business or profession is immune. Certain workplaces, both white and blue collar, are at increased risk. Truck drivers are more prone to depression and subsequent alcohol and drug abuse, than other Australians. Depression and other mental health disorders are comparatively high among the legal profession and doctors report substantially higher rates of psychological distress and attempted suicide compared to the Australian population generally.

Asking for help from an employer should not be viewed as a sign of weakness and it should not be delayed because of fears about adverse impacts on performance reviews or even the ability to retain a position. Disability discrimination legislation requires that workplaces do not discriminate against or harass workers with mental illness and the law should be effectively enforced in this regard. In the same way that workplaces have worked to encompass the flexible work needs of employees with physical disabilities, so too they must recognise that people with mental health problems can be valuable employees if they are provided with supportive environments.

The lead here must come from the federal government, itself a major employer. The timing is perfect; this week the government took delivery of the review of national mental health programs and services. It's time for action. Bold vision, clear articulated and evidence-based policies, well-targeted programs and sustained investment can deliver real returns - not just in the healthcare system but in welfare, employment, productivity and even tackling the budget deficit.

Dr Lesley Russell is Adjunct Associate Professor at the Menzies Centre for Health Policy at the University of Sydney.